Anesth Pain Med.  2018 Oct;13(4):409-414. 10.17085/apm.2018.13.4.409.

Effect of levetiracetam on rocuronium duration in patients undergoing cerebrovascular surgery

• Jeon YJ
• Kim MH

• KMID: 2436000
• DOI: http://doi.org/10.17085/apm.2018.13.4.409

Abstract

BACKGROUND
It has long been held that antiepileptics reduce the duration of action, and increase the requirement for, neuromuscular blocking agents. However, levetiracetam, a relatively novel antiepileptic agent, possesses different pharmacokinetic properties to other, conventional antiepileptics, such that its effect on neuromuscular blocking agents might also differ. The purpose of this retrospective study is to investigate the effect of levetiracetam on the clinical duration of rocuronium.
METHODS
In this study, the duration of neuromuscular blockade induced by rocuronium was compared between control and levetiracetam-receiving groups. The data were retrieved from one of our previous studies.
RESULTS
The control and levetiracetam groups comprised 16 and 13 patients, respectively, all of whom underwent cerebrovascular surgery. Subjects received supplementary rocuronium (0.15 mg/kg) whenever the train-of-four count reached 2 during surgery. The interval between supplementary rocuronium (0.15 mg/kg) injections was significantly longer in the levetiracetam vs. control group (50 and 39 minutes, respectively; P = 0.036).
CONCLUSIONS
The present results challenge the convention that antiepileptics decrease the duration of action of neuromuscular blockers, thereby alerting clinicians to the possibility of prolonged neuromuscular blockade in patients taking levetiracetam. Anesthetic management should encompass careful neuromuscular monitoring in such patients.

Keyword

Anticonvulsants; Neuromuscular blockade; Neuromuscular nondepolarizing agents

MeSH Terms

Anticonvulsants
Humans
Neuromuscular Blockade
Neuromuscular Blocking Agents
Neuromuscular Monitoring
Neuromuscular Nondepolarizing Agents
Retrospective Studies
Anticonvulsants
Neuromuscular Blocking Agents
Neuromuscular Nondepolarizing Agents

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